Recognising adult abuse and what to do about it!
Who is this guidance for? 1 Who is a Vulnerable Adult? 3 Why do we need to protect Vulnerable Adults? 3 What is adult abuse? 4 Who might the abuser be? 8 Where might the abuse occur? 8 How can you be alert to signs of abuse? 9 What should you do if you suspect abuse? 10 You should now ask yourself 14 Contact Numbers 16
This guidance is for everyone who is employed or works in a voluntary capacity, permanently or occasionally, with vulnerable adults in any setting or context. This includes individuals who work in: Health and Social Care Trusts Private, voluntary and community sectors All Social Housing including Sheltered and Supported Housing The Police Service of Northern Ireland Regulation of services Regulation of staff Services regulated by the Regulation and Quality Improvement Authority Relevant education and training 1
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A vulnerable adult is any person aged 18 years or over who is, or may be, unable to take care of him or herself or who is unable to protect him or herself against significant harm or exploitation. This may be because he or she has a mental health problem, a disability, a sensory impairment, is old and frail, or has some form of illness. Because of his or her vulnerability the individual may be in receipt of a care service in his or her own home, in the community or be resident in a residential care home, nursing home or other institutional setting. Vulnerable adults are entitled to have their civil and human rights upheld and to live a life free from abuse. They need to be treated with respect and dignity, be able to choose how to live their lives independently. They should be afforded the opportunity to participate in their local community as active citizens. 3
They should also be able to fulfill personal aspirations and realise potential in all aspects of their daily lives. This includes having access to advocacy or support services and to have their voice heard in decisions that affect their lives. If abuse does occur, vulnerable adults also need to be assured that they will be protected by the law and have their civil and human rights upheld in the course of any investigation that takes place. Abuse is a violation of an individual s human and civil rights by any other person or persons. Abuse can take many forms: Physical Abuse Including: hitting slapping pushing kicking burning giving a person medicine that may harm them restraining disciplining a person in an inappropriate way. 4
Possible Signs: fractures bruising burns pain marks not wanting to be touched. Psychological Abuse Including: emotional abuse verbal abuse humiliation bullying the use of threats. Possible Signs: being withdrawn too eager to do everything they are asked showing compulsive behaviour not being able to do things they used to not being able to concentrate or focus. Financial or Material Abuse Including: stealing from the person cheating them using them for financial gain putting pressure on them about wills, property, inheritance or financial transactions misusing or stealing their property, possessions or benefits. 5
Possible Signs: having unusual difficulty with finances not having enough money being too protective of money and things they own not paying bills not having normal home comforts. Sexual Abuse Including: direct or indirect sexual activity where the vulnerable adult cannot or does not agree to it. Possible Signs: physical symptoms include genital itching or soreness or having a sexually transmitted disease using bad language not wanting to be touched behaving in a sexually inappropriate way changes in appearance. Neglect or Acts of Omission Including: withdrawing or not giving the help that a vulnerable adult needs, so causing them to suffer. 6
Possible Signs: having pain or discomfort being very hungry, thirsty or untidy failing health changes in behaviour. Discriminatory Abuse Including: abusing a person because of their ethnic origin, religion, language, age, sexuality, gender or disability. Possible Signs: the person is not receiving the care services they require their carer is overly critical or makes insulting remarks about the person the person is made to dress differently from how they wish. The above list is meant as a guide and is not intended to be exhaustive. 7
It can be anyone: A partner, child, relative or friend. A paid or volunteer carer. A health, social care or other worker. A person claiming to be an employer of one of the above. A stranger. Abuse can happen anywhere: In someone s own home. At a carer s home. Within day care, residential care, nursing care or other institutional setting. At work or in educational settings. In rented accommodation or commercial premises. In public places. 8
You may see or hear something happen. A vulnerable adult may disclose an allegation to you. A colleague, family member or somebody else may tell you something that causes you concern. You may notice injuries or physical signs that cause you concern. You may notice either the victim or perpetrator behaving in a certain way that alerts you something may be wrong. 9
Remember your role is primarily supportive rather than Investigative. DO: Be open and honest about your concerns. Stay calm. Listen very carefully. Ensure that no one is in immediate danger. Call for emergency services if urgent medical / police help is required. Be aware that medical and forensic evidence might be needed. Encourage the person not to wash or bathe as this could disturb medical/forensic evidence. Tell the person that they did the right thing in telling you. Express concern and sympathy about what has happened. Reassure that the information will be taken seriously and give information about what will happen next. Let the person know that they will be kept involved at every stage; that they will be told the outcome and who will do this. 10
Give the person contact details so that they can report any further issues or ask any questions that may arise. Explain that you must tell your Line Manager or Designated Officer. Inform your Line Manager or Designated Officer immediately. Explain what you have heard or seen, that has given rise to your concerns. Give as much information as possible. DO NOT: Stop someone disclosing to you. Be afraid to act on your concerns. Press the person for more details. Promise to keep secrets or make promises you cannot keep. Gossip about the disclosure or pass on the information to anyone who does not have a legitimate need to know. Contact the alleged abuser. Attempt to investigate yourself. Tidy up, as this may disturb forensic evidence. Be judgemental. Leave details of your concerns on a voicemail or by e-mail. 11
If you are employed within the statutory, voluntary, private or independent sectors, you should report your concerns to your line manager whose responsibility it will be to refer these concerns to the appropriate HSC Trust Adult Protection Co-ordinator or Designated Officer with responsibility for Adult Protection. If you are a volunteer, discuss your concerns with your organisation s Designated Officer. If you have raised your concerns in the above way but either the vulnerable person or your line manager is reluctant to proceed with the referral, you should make a record and contact your HSC Trust s Adult Protection Co-ordinator or a Designated Officer with responsibility for Adult Protection. If your concerns involve a manager, refer to a more senior manager or contact the HSC Trust s Adult Protection Co-ordinator or a Designated Officer within a Trust with responsibility for Adult Protection. 12
If all mechanisms for reporting allegations of abuse have been exhausted without your concern being taken seriously, it should be noted that the Public Interest Disclosure (Northern Ireland) Order 1998 provides for the active safeguarding and protection of what are commonly known as whistle-blowers. 13
Am I familiar with my organisation s Safeguarding Adults Policy? Have I or my line manager access to Safeguarding Vulnerable Adults: Regional Adult Protection Policy and Procedural Guidance? Would I know how to recognise the signs of abuse? Do I know who to contact to talk about or report a suspicion of abuse? Do I know what to do if I suspect abuse? Do I know what not to do if I suspect abuse? Do I need further training? If you require any further information please consult with your line manager. 14
Northern Health and Social Care Trust Normal working hours (9am to 5pm) 028 2563 5558 Out of hours (5pm to 9am) 028 9446 8833 South Eastern Health and Social Care Trust Normal working hours (9am to 5pm) 028 9266 5181 extension 4544 Out of hours (5pm to 9am) 028 9056 5444 Southern Health and Social Care Trust Normal working hours (9am to 5pm) 028 3083 2650 Out of hours (5pm to 9am) 028 3083 5000 Belfast Health and Social Care Trust Normal working hours (9am to 5pm) 028 9056 5707 Out of hours (5pm to 9am) 028 9056 5444 16
Western Health and Social Care Trust Normal working hours (9am to 5pm) 028 7131 4090 Out of hours (5pm to 9am) 028 7134 5171 Police Service of Northern Ireland numbers Emergency 999 Non-emergency and general enquiries 0845 600 8000 Helpline numbers 24-hour Domestic Violence helpline 0800 917 1414 Action on Elder Abuse helpline 0808 808 8141 Other sources of advice The Older People s Advocate - 028 9031 6383 17
This leaflet is available in other formats and languages on request. This leaflet is available to download at: www.dhsspsni.gov.uk/adultawstaff.pdf and www.nidirect.gov.uk/adultawstaff.pdf